BACKGROUND AND OBJECTIVES: About one third of all people experience tinnitus in their life. And insomnia is the second most common symptom in tinnitus patients, following hearing disturbance. The aim of this study was to define the influence of insomnia on the clinical features of tinnitus patients and to assess the relation of tinnitus to insomnia and depression. SUBJECTS AND METHOD: The consecutive 197 patients with tinnitus were enrolled from May 2012 to May 2013 for this study. All patients with tinnitus filled out the following questionnaire, Visual Analogue Scale, Tinnitus Handicap Inventory (THI), Beck Depression Inventory (BDI), and Pittsburgh Sleep Quality Index (PSQI) for evaluating clinical features of tinnitus patients. Also we examined pure tone audiometry and tinnitogram for evaluating audiologic characteristics. RESULTS: When the insomnia was defined as more than five scores in PSQI, 46 of 197 patients had insomnia. Loudness of tinnitus was significantly higher in the tinnitus patients with insomnia group when compared to those of the tinnitus without insomnia group (p=0.018). The score of THI and BDI were significantly higher in the tinnitus with insomnia group, too (p=0.003, <0.001, respectively). A strong correlation (r=0.616, p<0.001) was shown between THI score and BDI score in both groups. CONCLUSION: It appears, due to the high possibility that depression and insomnia are related in tinnitus patients with insomnia, that proper evaluations about sleep disturbance and depression of tinnitus patients are necessary to produce better therapeutic results.
Audiometry ; Depression* ; Hearing ; Humans ; Surveys and Questionnaires ; Sleep Initiation and Maintenance Disorders* ; Tinnitus*

OBJECTIVE: To evaluate the change of clinical characteristics of prostatic cancer after the introduction of PSA (Prostate specific antigen) assay and TRUS (Transrectal ultrasonography), we retrospectively reviewed the medical records of 155 patients with prostatic adenocarcinoma who were managed at Seoul National University Hospital from January 1985 to December 1994. MATERIALS AND METHODS: Patients were stratified into 2 groups (Group I: 45pts{1985-1989} and Group II: 110pts{1990-1994}) by the year 1990 when our hospital began to use PSA assay and TRUS to detect prostatic cancer. PSA was measured by monoclonal radioimmunometric assay (ELSA-PSA). Tumor staging consisted of DRE (digital rectal. examination), TRUS, CT, MRI, simple bone X-ray and radionuclide bone scan. Clinical characteristics of 2 groups were compared. RESULT: Proportion of younger pts increased in group II but this was not statistically significant (p>0.05 by chi-square test). Number of pts were annually increasing , especially after the year 1990 when PSA assay and TRUS were introduced into clinical practice. Despite use of PSA and TRUS, the number of clinically localized pts did not differ between 2 groups. There was no difference in distribution of chief complaints between 2 groups. There were 3 pts who were detected by increased PSA alone. CONCLUSION: Prostate cancer incidence is increasing and will substantially increase in the future on the basis of increasing tendency to the old population, improved cancer detection and improved public awareness. More than 70% of pts have metastases or regional extension (Stage C or D). These dismal statistics constitute the main reason for early detection programs in the population at large.
Adenocarcinoma ; Humans ; Incidence ; Magnetic Resonance Imaging ; Medical Records ; Neoplasm Metastasis ; Neoplasm Staging ; Prostate* ; Prostate-Specific Antigen* ; Prostatic Neoplasms* ; Retrospective Studies ; Seoul

OBJECTIVES: The purpose of this study was to develop the Korean version of the Social Adjustment Scale II-Revised Version (KSAS II-RV) in the schizophrenics. METHODS: KSAS II-RV was administered to 67 schizophrenic patients and 78 matched normal controls for examining the reliability and validity. RESULTS: Data analysis showed statistically significant reliabilities and validities of KSAS II-RV. The test-retest reliability, inter-rater reliability, and internal consistency for total scores of KSAS II-RV were 0.85, 0.89. and 0.87, respectively. Evidence for discriminant validity of KSAS II-RV comes from the results that the mean scores of schizophrenic patients were significantly high than those of normal controls. Construct validity was assessed by calculating the 10 inter-subareas correlations of the KSAS II-RV, and all except the sexual adjustment area were statistically significant. Significant correlations between the global area scores of KSAS II-RV and those of Global Assessment of Functioning Scale lend support for the concurrent validity of this instrument indirectly. CONCLUSION: KSAS II-RV was found to be a valid and reliable instrument which can be used to evaluate the degree of social adjustment in the schizophrenic patients.
Humans ; Reproducibility of Results* ; Schizophrenia ; Social Adjustment* ; Statistics as Topic

OBJECTIVE: The aim of this study was to compare and analyze the effectiveness of different regimens in the treatment of malignant gestational trohphoblastic disease from 1981 to 2001. MATERIALS AND METHODS: This study included 307 patients with malignant gestational trophoblastic disease, who were admitted in Chonnam National University Hospital from 1981 to 2001. Remission rate, remission induction period, toxicity of chemotherapeutic agents depending on risk group and stages were analyzed. RESULTS: While stage I and II showed 100% of remission rate, stage III and IV showed 99.2%, 64.7% of remission rate respectively, resulting in 99.7% of overall remission rate. From 1981 to 1988, average number of cycle and periods for complete remission were 3.4 cycles and 80.3 days for low risk GTT, 6.2 cycles and 144.8 days for high risk GTT. From 1989 to 2001, average number of cycle and remission induction period were 4.1 cycles and 69.9 days, 5.3 cycles and 88.9 days, 6.6 cycles and 162.2 days for low, middle, and high risk GTT, respectively. As adjuvant therapy, 3 cases of hysterectomy and 2 cases of lobectomy were done. And radiation therapy was done on 2 cases of lung lesions and 1 cases of brain lesion. Etoposide and Actinomycin D caused less hepatotoxicity than Methotrexate did. EMA regimen shortened the overall period of treatment and caused less side effect, showing effectiveness equivalent to that of EMA CO regimen. With same therapeutic effect, less side effect and shortened administration period, EMA regimen might be able to substitute EMA CO regimen in high risk GTT. However, there should be more clinical trials before confirmation of its superior therapeutic efficacy over EMA CO regimen. CONCLUSION: When chemotherapy combined with adjuvant therapy such as operation and irradiation was done on appropriate patient group, which were selected based on risk factors and stage, it produced higher remission rate. For better therapeutic outcome, there should be further study on early detection technique and therapeutic effect of other chemotherapeutic agents.
Brain ; Dactinomycin ; Drug Therapy ; Etoposide ; Gestational Trophoblastic Disease* ; Humans ; Hysterectomy ; Jeollanam-do ; Lung ; Methotrexate ; Remission Induction ; Risk Factors

Concurrent sphincteric incontinence and organic impotence are not uncommon. Simultaneous implantation of the artificial sphincter and penile prosthesis is an effective proposal technically and functionally in these situations. A 44-year-old man presented with total incontinence and impotence, which developed after pelvic bone fracture. Urodynamic study showed sphincter incompetence. Pharmacologic & penile duplex sonography, nocturnal penile tumescence test confirmed arteriogenic impotence. Simultaneous implantation of an artificial sphincter(AMS 800) and a multicomponent inflatable penile prosthesis(AMS 700CXM) was done. For 5 months of follow-up the penile implant was functional, without incontinence. and there are no evidences of infection.
Adult ; Erectile Dysfunction ; Female ; Follow-Up Studies ; Humans ; Impotence, Vasculogenic ; Male ; Pelvic Bones ; Penile Erection ; Penile Prosthesis* ; Urodynamics

Intravascular papillary endothelial hyperplasia (IPEH) is a rare benign proliferation of intravascular endothelial cells. However, IPEH can be easily mistaken for an angiosarcoma, thus differential diagnosis is very important to avoid over-treatment. We report the case of a 22-year-old man who presented with small lobulating mass in nasopharynx. Computed tomography showed about 4 cm homogenous mass in the nasopharynx without extension into soft tissues. Complete surgical excision was done and biopsy during operation showed distended vessels and numerous papillae consist of endothelial cells lining a hyaline core. At follow up, no other complications were observed. Thus we present the case and a review of the literature.
Biopsy ; Diagnosis, Differential ; Endothelial Cells ; Follow-Up Studies ; Hemangiosarcoma ; Humans ; Hyalin ; Hyperplasia* ; Nasopharynx* ; Young Adult

Background: Now that it is possible to efficiently classify and save tissue images of laboratory animals using wholeslide imaging, many diagnostic models are being developed through transfer learning with Convolutional Neural Network (CNN). In this study, transfer learning was performed to gain toxicopathological knowledge using CNN models such as InceptionV3 and Xception. For the classification of tubular basophilia and mineralization, two representative background lesions that commonly occur in toxicological studies, accuracies of diagnosis were compared using MobileNetV2, Xception and InceptionV3. For the simultaneous detection of the two lesions, the accuracy was analysed using You Only Look Once version 4 (YOLOv4). Results: The accuracy of the classification models was as follows: MobileNetV2 (epoch 50, accuracy: 98.57%) > Xception (epoch 70, accuracy: 97.47%) > InceptionV3 (epoch 70, accuracy: 89.62%). In the case of object detection, the accuracy of YOLOv4 was 98.62% at epoch 3000. Conclusions Among the classification models, MobileNetV2 had the best accuracy despite applying a lower epoch than InceptionV3 and Xception. The object detection model, YOLOv4, accurately and simultaneously diagnosed tubular basophilia and mineralization, with an accuracy of 98.62% at epoch 3000.

PURPOSE: We aim to compare the erythropoietic effects of epoetin-alpha (EA, 4000 IU SC thrice a week) with those of darbepoetin-alpha (DA, 60ug IV weekly, conversion rate to EA=200:1). METHODS: Forty one stable hemodialysis patients were enrolled in this randomized crossover study. After a washout period of erythropoietin stimulating agents (ESA), the patients with hemoglobin (Hb) level of < or =11.0 g/dL were randomly assigned to DA or EA and we measured Hb and reticulocyte levels. When Hb reached >11.0 g/dL, we stopped ESA. When Hb level decreased to < or =11.0 g/dL again, we switched to alternative ESA and repeated the rest of the steps. RESULTS: Thirty six patients (M:F=20:16, age 62+/-11 years, Kt/V 1.65, nPCR 1.13 g/kg/day) completed the study. No significant differences were observed in baseline parameters between DA and EA during the period of the clinical trial. The rate of Hb level increase (EA 0.29 g/dL/week, DA 0.30 g/dL/week, p=0.76) and decrease (EA 0.45 g/dL/week, DA 0.38 g/dL/week, p=0.14) were not different between two periods. After ESA stopped, the duration of decreased Hb level of < or =11.0 g/dL was not significantly different (4 weeks in EA vs. 3.9 weeks in DA, p=0.86). Erythropoietin resistance index was 10.59 in the EA period. It was not significantly different from 10.97 in DA period (p=0.49). Nine patients (25%) showed a >30% change in EA efficiency relative to DA efficiency. CONCLUSION: There was no significant difference in erythropoietic parameters for both EA and DA.
Anemia ; Cross-Over Studies ; Erythropoietin ; Hemoglobins ; Humans ; Recombinant Proteins ; Renal Dialysis ; Reticulocytes ; Darbepoetin alfa ; Epoetin Alfa

PURPOSE: Traditionally, an interval of 4 to 6 weeks has been recommended after prostate biopsy before open radical prostatectomy. However, such an interval is not explicitly specified in robot-assisted laparoscopic radical prostatectomy (RALP). This study was designed to determine whether the interval from prostate biopsy to RALP affects surgical difficulties. MATERIALS AND METHODS: Between January 2008 and May 2009, a total of 237 men underwent RALP in our institution. The interval from biopsy to RALP was categorized as follows: < or = 2 weeks, >2 to < or = 4 weeks, >4 to < or = 6 weeks, >6 to < or = 8 weeks, and >8 weeks. Multivariate analysis was used to identify whether the interval from prostate biopsy to RALP was an independent predictor of operative time, estimated blood loss (EBL), margin positivity, continence, and potency. RESULTS: Among the 5 groups, there were no significant differences in age, body mass index (BMI), preoperative serum prostate-specific antigen (PSA), prostate volume, or preoperative International Index of Erectile Dysfunction-5 score (all p>0.05). In the multivariate analysis, operative time was significantly associated with prostate volume. EBL was associated with prostate volume and BMI. Margin positivity was associated with preoperative serum PSA, prostate volume, and biopsy Gleason score. Postoperative continence and potency were significantly associated with age. However, in univariate and multivariate analyses, the interval from biopsy to RALP was not significantly associated with operative time, EBL, margin positivity, postoperative continence, or potency (all p>0.05). CONCLUSIONS: Our data suggest that the interval from prostate biopsy to RALP is not related to surgical difficulties.
Biopsy ; Body Mass Index ; Humans ; Male ; Multivariate Analysis ; Neoplasm Grading ; Operative Time ; Prostate ; Prostate-Specific Antigen ; Prostatectomy ; Prostatic Neoplasms

BACKGROUND: Atopic dermatitis (AD) is characterized by itching and eczema-like skin lesions, and its symptoms alleviate with age. Recently, the prevalence of AD has increased among adolescents and adults. The increasing prevalence of AD seems to be related to westernized lifestyles and dietary patterns. OBJECTIVE: The aim of this study was to evaluate the dietary patterns and nutrient intake of patients with AD. METHODS: The study population consisted of 50 children with AD who visited the Department of Dermatology at Kangnam Sacred Heart Hospital, Seoul, Korea from May 2008 to May 2009. Physical condition and calorie intake were evaluated using the Eczema Area and Severity Index score and Food Record Questionnaire completed by the subjects, and the data were analyzed using the Nutritional Assessment Program Can-pro 3.0 (The Korean Nutrition Society, 2005) program to determine the gap between the actual ingestion and average requirements of 3 major nutrients (i.e. carbohydrates, proteins, and lipids), vitamins (i.e. A, B, C, and E), niacin, folic acid, calcium, iron, phosphorus, and zinc in all subjects. RESULTS: The intake rate of proteins was 18.02% (recommended dietary allowance [RDA], 7%~20%), of carbohydrates was 67.7% (RDA, 55%~70%), and of lipids was 14.24% (RDA, 15%~30%). Thirty-one subjects (62%) showed deficiency of folic acid, and 21 subjects (42%), of iron supplements. CONCLUSION: Essential nutrient intake tends to be lower in AD patients than in healthy subjects, and this low intake is closely related to the severity of AD.
Adolescent ; Adult ; Calcium ; Carbohydrates ; Child* ; Dermatitis, Atopic* ; Dermatology ; Eating ; Eczema ; Folic Acid ; Food Preferences ; Heart ; Humans ; Iron ; Korea ; Life Style ; Niacin ; Nutrition Assessment ; Phosphorus ; Prevalence ; Pruritus ; Seoul ; Skin ; Vitamins ; Zinc ; Surveys and Questionnaires